4 Bronchology – Past, Present and Future Diagnostic Procedures Gustav Killian, the father of bronchoscopy, was appointed Professor of Oto- Rhino-Laryngologie at the University of Freiburg in 1892. In 1897, he success- fully removed a bone splinter from the right bronchus of a Black Forest farmer. Admitted as an emergency case, the patient had difficult respiration, blood was streaming from his mouth and he had mucoid expectorations. He had ingested the piece of bone with his soup. Listening to his breathing, a wheezing noise could be heard in his right lung area. Killian used a head mirror as light source, an esophagoscope (size 33.5 cm), (Fig. 1a) and forceps to remove the bone splinter, which was 11 mm long and 3 mm thick. Killian became famous and his clinic attracted patients from far and wide for his expertise in removing foreign bodies. He removed bones, beans, buttons, coins and a tin whistle. A family traveled all the way from Montevideo/Uruguay with their seven year old daughter who had inhaled a tin whistle. The grateful family sailed back to South America after the child was saved. Killian devised and improved instruments to observe and explore the bronchial “Terra Incognita”. In May 1898, about one year after his initial experiments, he described some basic facts of modern bronchoscopy in Münchner Medizini- sche Wochenschrift: “The bronchial tubes are elastic, mildly flexible and can be dilated. But most importantly, they can be displaced. One should not imagine the bronchial tree to be stiff as if it were made of wrought iron. On the contrary, both the entire structure and the different branches show pulsating and respira- tory movement. It is therefore obvious that the bronchi do not resist the move- Fig. 1 The most important milestones in the development process of rigid and flexible bronchoscopes: a – Gustav Killian’s Bronchoscope, external light source; b – Chevalier Jackson’s Bronchoscope with a small distal light bulb and built-in suction tube; c – Bronchoscope with Nitze’s conventional lens system: d – KARL STORZ telescope with fiber optic light transmission and Hopkins rod lens system; e – KARL STORZ Bronchoscope tube with inserted Hopkins^® telescope; f – KARL STORZ Broncho-Fiberscope a b c d e f The History of Bronchoscopy – an Overview Back –––––––Table of Contents–––––––Next Back –––––––Table of Contents–––––––Next